This invention relates to a health benefit processing system. More specifically, it relates to an automated health benefit processing system which provides cost savings.
In recent years costs associated with health care have been rapidly increasing. A variety of systems which utilize specially designed computer hardware have been developed in an effort to ease the burden of processing claims relating to health benefits and to try to contain the rising costs.
An article in the Jan. 9, 1991 edition of the Wall Street Journal at page B1 discusses several of these systems. According to the article, a system provided by GMIS Clinical Information Service uses a database of health procedures and costs to evaluate claims. Another system, provided by Health Information Technologies, provides an electronic network linking physicians to insurers to eliminate paper claim forms. Yet another system allows hospitals and insurers to monitor the quality of health care delivery and is provided by MediQual.
None of these systems, however, provide an automated benefit processing system which reduces health care costs by quickly informing purchasers of medical services of market conditions such as the identity of providers of the services, their qualifications and their prices. Such a system, therefore, is needed to help contain increasing health care costs.